|These are episodic disorders in
which both affective and schizophrenic symptoms are
prominent within the same episode of illness, preferably
simultaneously, but at least within a few days of each
other. Their relationship to typical mood (affective)
disorders and to schizophrenic disorders is uncertain.
They are given a separate category because they are too
common to be ignored. Other conditions in which affective
symptoms are superimposed upon or form part of a pre-existing
schizophrenic illness, or in which they coexist or
alternate with other types of persistent delusional
disorders, are classified under the appropriate category.
Mood-incongruent delusions or hallucinations in affective
disorders do not by themselves justify a diagnosis of
Patients who suffer from recurrent schizoaffective episodes, particularly those whose symptoms are of the manic rather than the depressive type, usually make a full recovery and only rarely develop a defect state.
A diagnosis of schizoaffective disorder should be made only when both definite schizophrenic and definite affective symptoms are prominent simultaneously, or within a few days of each other, within the same episode of illness, and when, as a consequence of this, the episode of illness does not meet criteria for either schizophrenia or a depressive or manic episode. The term should not be applied to patients who exhibit schizophrenic symptoms and affective symptoms only in different episodes of illness. It is common, for example, for a schizophrenic patient to present with depressive symptoms in the aftermath of a psychotic episode (see post-schizophrenic depression). Some patients have recurrent schizoaffective episodes, which may be of the manic or depressive type or a mixture of the two. Others have one or two schizoaffective episodes interspersed between typical episodes of mania or depression. In the former case, schizoaffective disorder is the appropriate diagnosis. In the latter, the occurrence of an occasional schizoaffective episode does not invalidate a diagnosis of bipolar affective disorder or recurrent depressive disorder if the clinical picture is typical in other respects.